Facial Contour Restoration in BarraquerSimons Syndrome Using Two Free Anterolateral Thigh Flaps

Abstract

Barraquer-Simons syndrome, or cephalothoracic lipodystrophy, is characterized by fat atrophy of an obscure pathogenesis involving the face and, eventually, the thoracic region. Simultaneously, fat hypertrophy of the lower extremities, a nephropathy, and complement anomalies may be observed. We presented two patients with the typical features of this disease, as well as a previously undescribed vascular and perivascular inflammation of the facial arteries and veins that caused problems with microvascular anastomosis. Both patients were treated with a bilateral transfer of the anterolateral thigh flap, which has not been reported previously. In contrast to other transfers previously reported, the fat tissue of this flap is never affected by the disease and is redundantly present. Placing the fascia of the flaps toward the skin allows for strong fixation to the temporal region and guarantees a stable result with a smooth facial contour.

Soft tissue augmentation for restoration of facial contour deformities using the free SCIA/SIEA flap

“…There are several requirements for the tissue or material for tissue augmentation: (1) it must be malleable, to be formed according to defect; (2) once in position, it must undergo minimal change in size and position; and (3) and anterolateral tight flap. 19 However, a consensus on the ideal method has not yet been reached, and investigations to discover the ideal flap continues. Omental flap was used for facial since beginning free flap transfer.…”

“…Many free flaps have been applied in clinical patients, including groin, 5-7 radial forearm, 8 scapular, 9 parascapular, 10,11 latissimus dorsi flap, 12 serratus, 13 TRAM, 14 omental free flap, 15,16 superficial inferior epigastric flap, 17 deep inferior epigastric perforator flap, 18 and anterolateral tight flap. 19 However, a consensus on the ideal method has not yet been reached, and investigations to discover the ideal flap continues. Omental flap was used for facial since beginning free flap transfer.…”

Rombergʼs Disease Associated with Hornerʼs Syndrome: Contour Restoration by a Free Anterolateral Thigh Perforator Flap and Ancillary Procedures

“…[51][52][53][54][55][56][57][58][59] It has also been used for facial contour restorations. 47,48,60 In recent years, the versatility of the anterolateral thigh flap has even led some authors to interpret the technique as the ideal soft-tissue flap. 61,62 The vascular anatomy and its variations have been studied in detail, [63][64][65] and it has a low donor-site morbidity.…”

Facial contour restoration in Barraquer‐Simons syndrome using two free tram flaps: Presentation of two case reports and long‐term follow‐up

“…In the bilateral transfer of the anterolateral thigh flap, the placement of the fascia of the flaps toward the skin allows for stronger fixation to the temporal region. 15,16 However, sagging could occur because of the loose consistency of the adipose tissue in these flaps.…”